Marianthe Dagar Gormanous, MS, LDN, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

858842 Issued in LA

Practice address

2495 Shreveport Hwy # 71
Pineville, LA 71360-4044

Phone

(318) 473-0010

NPI assigned

Nov 9, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mimi Gormanous Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Alexandri VA Medical Center

  • General Acute Care Hospital
  • Pineville, LA
  • NPI 1326123050
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289260800000",
    "number": "1215238126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2495 SHREVEPORT HWY # 71",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713604044",
            "telephone_number": "318-473-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 SHREVEPORT HWY # 71",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713604044",
            "telephone_number": "318-473-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMANOUS",
        "first_name": "MARIANTHE",
        "middle_name": "DAGAR",
        "name_prefix": "Mrs.",
        "credential": "MS, LDN, RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-09",
        "last_updated": "2010-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "LA",
            "license": "858842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIMI",
            "last_name": "GORMANOUS",
            "credential": "MS, LDN, RD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Selena Gaylor
• Joe Gentry
• Lakayal Givens
• Gloria Phillips
• Samuel Gonzalez, M.D.
• Shaina T. Goudeau, MSPT
• Peggy H Gramates, MD
• Karri Lee Gramlich-Mabou, DC
• Toni Grant, MD
• Kateshia Green, LCSW

• Registered Dietitian in Pineville, LA
• Providers in Pineville, LA by specialty
• Registered Dietitian in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.